St. Mary's Volunteer Applications

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St. Mary's Junior Volunteer Application

Basic Information

* First name

Middle initial

* Last name

First name (preferred)

* DOB

* Last 4 of SSN

How did you hear about the St. Mary's Volunteer Program

Contact Information

* Phone Number

* E-mail

Home Address

* Line 1

Line 2

* City

* State

* Zip/postal

About You

Your School

Grade entering in Fall

* List School Activities you Partcipate in: (sports, clubs, committees)

* List Outside Activities/Volunteer experience: (church, clubs, hobbies, special interests, organizations)

* What interests you about volunteering at St. Mary's?

Do you have any limitations or health conditions which should be taken into consideration before determining a volunteer assignment?

If yes, please list any limitations and accomodations you require here.

Do you have any relatives working in the St. Mary's Health System?

If yes, list your relatives working at St. Mary's including employee's name and department.

Parent/Guardian

Upon acceptance into the program, we will be reaching out to your parent or guardian with an overview of the program and paperwork to complete. Please be sure the person you list in these fields is authorized to sign paperwork on your behalf.

* Parent/Guardian Contact Name

* E-mail

* Phone (Mobile)

Phone (Home)

Phone (Business)

* Mailing Address

* City

* State

* Zip/postal

References

Please provide two school, church, volunteer or work references. Please do not list any friends or relatives):

Reference 1

* Name

Relationship

Organization

* Phone

* E-mail

Reference 2

* Name

Relationship

Organization

* Phone

* E-mail

Schedule Preference

Once our volunteer selections have been made we will work to build a schedule that best fits everyone's schedules. This information provided will be helpful in the creation of that schedule. For each day of the week indicate if the day works for your schedule. We will do our best to pick applicants top selections. A final schedule will be released prior to the summer session starting and adjustments can be made at that time.

Monday

Tuesday

Wednesday

Thursday

Friday

Number of Desired Days Per Week

All Junior Volunteers must commit to one day per week from 8 AM to 4 PM. Some volunteers choose to come in more than once a week. Please indicate how many days per week you plan to commit.

Uniform Selection

Each volunteer will be provided with a polo shirt. Please select your size below. Sizing guides can be found at the links below:
Men's Styles
Ladies's Styles

Uniform Style Selection

Uniform Size

Agreement to Requirements

* By checking this box, you confirm that you have read and understood the requirements for the Junior Volunteer program listed at the top of this application. You also affirm that, to the best of your knowledge, you can meet the immunization requirements and time commitments outlined.

Basic Information

Contact Information

About You

Parent/Guardian

References

Schedule Preference

Uniform Selection

Each volunteer will be provided with a polo shirt. Please select your size below. Sizing guides can be found at the links below: Men's Styles Ladies's Styles

Agreement to Requirements

Each volunteer will be provided with a polo shirt. Please select your size below. Sizing guides can be found at the links below:
Men's Styles
Ladies's Styles